Written Answers Monday 23 June 2008

Scottish Executive

Dentistry

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive whether dental patients who are not registered with the NHS have full rights of access to out-of-hours NHS emergency treatment.

Shona Robison: NHS boards have out-of-ours emergency services in place which un-registered patients can access. The provision of these services varies amongst boards. Dentists are not obliged to provide out-of-hours NHS emergency treatment to patients who are not registered with them under NHS arrangements.

Diabetes

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive how many people have been diagnosed with (a) type 1 and (b) type 2 diabetes in each of the last five years.

Shona Robison: The information requested is given in the following table.

  

 Year
 Type 1
 Type 2


 2002
 1,036
 14,401


 2003
 1,091
 15,688


 2004
 1,026
 17,071


 2005
 950
 16,144


 2006
 971
 16,577


 2007
 1,052
 17,037



  Source: Scottish Diabetes Survey / SCI-DC.

Diabetes

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive what action is being taken to ensure that the level of transitional care is appropriate for children with diabetes to move to adult services.

Shona Robison: The Diabetes Action Plan, published in June 2006, highlights the importance of ensuring that young people with diabetes experience a smooth transition from services provided by paediatric teams into the adult service.

  The diabetes managed clinical networks are expected to have in place plans and protocols for such transitions. From information they provided in March 2008, it is clear that each board either has these arrangements in place, or is in the process of developing them.

  Transitional care is part of the remit of the sub-group set up by the Scottish Diabetes Group to look at issues relating to the management of type 1 diabetes.

  We welcome the advice for young people themselves on the issue of moving from children to adult services contained in the information pack Making Connections, recently published by Diabetes UK Scotland.

Diabetes

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive what psychological support is available for people with type 1 diabetes.

Shona Robison: We set out in Better Health, Better Care our recognition of the need for improved psychological support for people living with any long-term condition. An important way of achieving that aim is to make sure that people are aware of the full range of information and support available to them, including the contribution of the voluntary sector.

  The Diabetes Action Plan, published in June 2006, recognised the need to improve access to psychological and emotional support for people with diabetes in all parts of Scotland. It placed a specific responsibility on the diabetes managed clinical networks to ensure that existing staff training courses are informed by behaviour change models and a sense of the importance of empowering people with diabetes.

  The Scottish Diabetes Group has encouraged the development of a training course designed to achieve improvements in the training of healthcare professionals involved with diabetes care with respect to psychological issues, including the identification of depression and anxiety. The courses became available in January 2008 and will run for two years.

  The Scottish Government is also supporting a three-year initiative with the Royal College of General Practitioners and partners which involves working with community health partnerships on the services provided by GP practices for those with diabetes who are also suffering from depression.

Domestic Abuse

Nigel Don (North East Scotland) (SNP): To ask the Scottish Executive what progress has been made since September 2007 on extending the benefits of the Glasgow pilot domestic abuse court.

Kenny MacAskill: This government’s goal is to enable all cases of domestic abuse which come before a court in Glasgow to benefit from specialist arrangements to support victims, bring offenders quickly to justice, and reduce repeat offending. We also aim to support initiatives by criminal justice agencies elsewhere in Scotland to improve the handling of this serious crime.

  I wish to record my thanks to the Glasgow Domestic Abuse Feasibility Study Group for their careful assessment of future options for a specialist court in Glasgow and for their report, which I publish today (Bib. number 45747) and which I have considered carefully in consultation with the sheriff principal for Glasgow and Strathkelvin. I endorse the group’s objective to extend the benefits of the current pilot court across the whole of the city. We will achieve that goal in stages, building on the success of the pilot court and taking full advantage of the wider reforms to summary justice as they reduce court congestion and free up scarce accommodation.

  As a first step, I can today announce that we will substantially increase the volume of cases being heard in the court, enabling it to hear all cases of domestic abuse arising in police divisions A & G within Glasgow. The Crown Office and Procurator Fiscal Service will expand its team of dedicated prosecution staff to service the specialist court. The Scottish Court Service will provide the judicial and other resources to enable the sheriff principal to increase the court’s capacity. The government is extending support for the ASSIST specialist victim support service, enabling more victims to benefit from early intervention, risk assessment and support throughout the court process. The specialist court will operate on an enlarged and on-going basis from this autumn.

  Domestic abuse cases arising in police division B in Glasgow will be identified for specialist handling within mainstream courts. The ASSIST service model will be adapted to extend support to them also. To the greatest extent possible, such cases will be programmed in such a way as to provide continuity of prosecution and judicial staff dealing these types of cases.

  Our wider reforms to summary justice should in due course create additional capacity within Glasgow’s court estate. It will be for the sheriff principal to decide how best to deploy that capacity. We will review the position with him once the summary justice reforms are well bedded in, some 18 months from now. Should he decide that there should be a second dedicated domestic abuse court we will help resource this.

  I made clear last September that Glasgow’s case for a dedicated domestic abuse court reflects the volume of this crime occurring in the city. But specialist courts are not the only means by which criminal justice agencies can improve their handling of such crime. I am today publishing a "toolkit" (Bib. number 45750) for local criminal justice boards and others with an interest in developing innovative and effective responses to domestic abuse within the criminal justice system. The toolkit outlines a range of approaches to domestic abuse. It will support self-assessment. It should lead to innovation and experiment.

  The announcement by the government and COSLA last week on the national delivery plan to support children and young people affected by domestic abuse sets the policy context for these initiatives on the handling of domestic abuse cases in court. Our overall strategy for addressing domestic abuse in Scotland encompasses prevention and early intervention approaches, as well as rigorous prosecution of crime. The measures I am announcing today therefore underpin this strategy. They confirm government’s commitment to a long-term programme of work, in Glasgow and elsewhere, fully to mobilise the resources of the justice system to deal with this crime and support its victims.

Enterprise

Bashir Ahmad (Glasgow) (SNP): To ask the Scottish Executive how it intends to promote young entrepreneurship in ethnic minority communities.

Fiona Hyslop: Promoting entrepreneurship as a career option for all young people is a priority for the Scottish Government if we want to ensure that we achieve our overall purpose of increasing sustainable economic growth. Through our new phase of Determined to Succeed, our strategy for enterprise in education, we will be focusing, more explicitly, on developing the entrepreneurial skills, as well as the enterprise and employability skills, of all our young people, including those from ethnic minority communities.

  In addition, wider promotion of support for business start-ups will be undertaken by Business Gateway at a local level and in partnership with Prince’s Scottish Youth Business Trust, specific activities will focus on young people, including ethnic minorities.

Health

Jamie Stone (Caithness, Sutherland and Easter Ross) (LD): To ask the Scottish Executive whether it is NHS policy that patients who purchase drugs that are not available through the NHS are denied further treatment under the NHS.

Shona Robison: Where the Scottish Medicines Consortium (SMC) do not recommend a particular drug or treatment for use in the NHS, NHS boards and clinicians in Scotland are expected to take full account of the advice provided.

  However, the decisions of clinicians in relation to the care of individual conditions are a matter of professional judgement. Where a clinician judges that a patient’s circumstances are exceptional, special arrangements are available within the relevant NHS board to consider, on a case-by-case basis, whether in these circumstances a drug or treatment (not recommended by the SMC) can be made available.

  A fundamental principle of the NHS is that care is free at the point of delivery. In the interests of patient safety and good clinical governance, a patient cannot be a private and an NHS patient for the treatment during the same episode of care.

  Guidance has been issued to NHS boards to set out the process to be followed where requests are received from patients to supplement NHS treatments with drugs or other treatments not currently available from the NHS following SMC and/or NHS Quality Improvement Scotland advice. A copy of the guidance can be accessed via http://www.sehd.scot.nhs.uk/cmo/CMO(2007)03.pdf

  The Parliament’s Public Petitions Committee has considered the issue of "top-up" or "co-payments" for the purchase of drugs as part of their inquiry into the provision of cancer drugs in Scotland. The inquiry report is expected to be published in the near future and any recommendations related to this issue will be fully considered in due course.

Health

Jamie Stone (Caithness, Sutherland and Easter Ross) (LD): To ask the Scottish Executive how many patients have been denied NHS treatment because they have purchased drugs that are not available under the NHS.

Shona Robison: The planning and provision of NHS services is a matter for NHS boards. The decisions of clinicians in relation to the care of individual conditions are a matter of professional judgement.

  This information is not collected centrally.

Health

Jamie Stone (Caithness, Sutherland and Easter Ross) (LD): To ask the Scottish Executive what its policy is on co-funding NHS treatment.

Shona Robison: A fundamental principle of the NHS is that care is free at the point of delivery. In the interests of patient safety and good clinical governance, a patient cannot be a private and an NHS patient for the treatment of one episode of care.

  Guidance has been issued to NHS boards to set out the process to be followed where requests are received from patients to supplement NHS treatments with drugs or other treatments not currently available from the NHS following Scottish Medicines Consortium and/or NHS Quality Improvement Scotland advice. A copy of the guidance can be accessed via:

  http://www.sehd.scot.nhs.uk/cmo/CMO(2007)03.pdf.

  The Parliament’s Public Petitions Committee has considered the issue of "top-up" or "co-payments" for the purchase of drugs as part of their inquiry into the provision of cancer drugs in Scotland. The inquiry report is expected to be published in the near future and any recommendations related to this issue will be fully considered in due course.

Higher Education

George Foulkes (Lothians) (Lab): To ask the Scottish Executive whether it will draw to the attention of Scottish universities the provision of the Age Discrimination Act 2006 that makes it unlawful to discriminate in appointments on grounds of age.

Fiona Hyslop: Discrimination on the grounds of age is now unlawful in employment and vocational training. It is the responsibility of all employers, both public and private sector, to ensure that they comply with the Employment Equality (Age) Regulations 2006.

  Scottish higher education institutions are autonomous bodies and as such are responsible for ensuring that they operate in compliance with all current legislation.

Higher Education

George Foulkes (Lothians) (Lab): To ask the Scottish Executive which universities have provisions included in their standing orders which prohibit appointments on grounds of age.

Fiona Hyslop: This is a matter for higher education institutions which are autonomous bodies with responsibility for their own governance arrangements and therefore for the content of their charters, statutes, ordinances and statutory instruments. The information requested is not held centrally.

Higher Education

Christina McKelvie (Central Scotland) (SNP): To ask the Scottish Executive when the Joint Future Thinking Taskforce on Universities expects to report.

Fiona Hyslop: I am pleased to announce that the taskforce plans to publish our interim report on 24 June 2008. The report will be accessible at: http://www.scotland.gov.uk/Topics/Education/UniversitiesColleges/16640/hetaskforce .

  The report sets out:

  a shared ambition for universities in the 21st century;

  the agreed context within which universities will operate and their staff and students will live, work and study in the next 20 years;

  resource commitments which the taskforce believe should guide the Scottish Government in the funding of universities in the future;

  challenges that the Scottish Government is setting universities, and

  challenges that universities are setting the Scottish Government.

  I will be encouraging stakeholders to feed in their comments over the summer. The taskforce will reconvene in September to consider how best we respond.

  In parallel, John McClelland, Chair of the Scottish Funding Council will be undertaking a review of the funding council’s processes and procedures in readiness for the new role it will play in the future in relation to the governance of and funding policies for our universities.

Mental Health

Dr Richard Simpson (Mid Scotland and Fife) (Lab): To ask the Scottish Executive what funds have been allocated to Breathing Space telephone advice lines in 2008-09.

Shona Robison: The Scottish Government’s Mental Health Division has allocated £800,000 to NHS24 in 2008-09 to support the running, staffing and advertising of the Breathing Space advice line.

  In addition, NHS24 have allocated a further £225,000 to support Breathing Space in 2008-09.

Mental Health

Dr Richard Simpson (Mid Scotland and Fife) (Lab): To ask the Scottish Executive what funding will be allocated to Breathing Space telephone advice lines in (a) 2009-10 and (b) 2010-11.

Shona Robison: The Scottish Government’s Mental Health Division has allocated £800,000 to NHS24 in each of 2009-10 and 2010-11 to support the running, staffing and advertising of the Breathing Space advice line.

  In addition, NHS24 have allocated a further £225,000 to support Breathing Space in each of these years.

People with Dementia

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive what progress has been made to improve the early diagnosis and management of patients with dementia.

Shona Robison: From April 2008 NHS boards are required to achieve improvements in the early diagnosis and management of patients with dementia by March 2011. NHS boards will be supported in this work by the Mental Health Collaborative.

  In addition, we are investing £600,000 through Alzheimer Scotland and the Dementia Services Development Centre to examine better and earlier structured intervention, support and information for service users and families immediately following the first diagnosis of dementia. This initiative advances key findings from our recently published report on early intervention attention in Forth Valley.

People with Dementia

Nicol Stephen (Aberdeen South) (LD): To ask the Scottish Executive what consideration it has given to the report by the All-Party Parliamentary Group on Dementia, Always A Last Resort, and whether, in light of the report’s findings, it intends to consider changes to policies and guidelines in Scotland regarding the prescription of antipsychotic drugs to people with dementia in care homes.

Shona Robison: In Scotland, a number of policies and guidance documents already contain advice and information about the prescription of antipsychotic drugs to people with dementia in care homes.

  The Standards for Integrated Care Pathways for Mental Health published by NHS Quality Improvement Scotland (NHS QIS) provide a nationally agreed benchmark on the best approaches to social and health care management for those with dementia (Bib. number 44374). These include a specific standard to ensure people with dementia receive care to match their needs and includes advice that antipsychotic medication should be reserved for severe aggression or psychotic symptoms where other approaches have failed or would be inappropriate. NHS QIS are supporting NHS boards to implement the standards which are being accredited from 2008 onwards.

  SIGN Guideline 86 on the management of dementia includes a section about the use of antipsychotics which advises that these should be used with caution. The SIGN guideline was issued in 2006 and would be considered for review in 2009.

  In addition, the Care Commission and the Mental Welfare Commission for Scotland are working together to examine the issue of chemical restraint and consent in the administration of medicines in care homes for older people, through a series of focused inspections of care homes to be undertaken later this year. We will consider the findings when the organisations report.

People with Dementia

Nicol Stephen (Aberdeen South) (LD): To ask the Scottish Executive what consideration has been given to the risks posed by antipsychotic drugs to dementia patients.

Shona Robison: As with all medicines, the safety of antipsychotic drugs is continually monitored by the UK Medicines and Healthcare Products Regulatory Agency (MHRA) and the Commission for Human Medicines.

  The MHRA has advised that no antipsychotic drugs are currently licensed specifically for the treatment of the behavioural disturbances associated with dementia. However, medicines legislation allows for the use of unlicensed medicines if it is considered to be an appropriate treatment for an individual patient. In these circumstances the prescriber bears a greater degree of responsibility for the use of the medicine.

  The current advice in relation to the use of antipsychotics agents in dementia is that issued by the Committee on Safety of Medicines on 9 March 2004. This advice warned prescribers that there is a clear risk of stroke in elderly people with dementia who are treated with risperidone or olanzapine (two of the atypical antipsychotics) and the magnitude of this risk is sufficient to outweigh any likely benefits in the treatment of behavioural disturbances associated with dementia. Furthermore, the risk is a cause for concern in any patient with a high baseline risk of stroke. This advice was issued to healthcare professionals and is reproduced in the British national formulary issued free to prescribers.

  Subsequently in 2005, following completion of further studies, a Europe-wide review of this issue concluded that an increased risk of stroke in elderly people with dementia could not be excluded for other antipsychotics (atypical and conventional antipsychotics). As a result of this review the product information for all antipsychotics is being updated to include warnings about this risk.

People with Dementia

Nicol Stephen (Aberdeen South) (LD): To ask the Scottish Executive what research has been undertaken to establish whether care home residents with dementia are aware that they are commonly prescribed antipsychotic drugs and the percentage of residents who refuse to take such drugs.

Shona Robison: The Care Commission and the Mental Welfare Commission are working in partnership to examine the issue of chemical restraint and consent in the administration of medicines in care homes for older people. The joint working will include consideration of the use of sedative and antipsychotic medication as a form of restraint, procedures for certifying adults with incapacity and arrangements for securing consent. It is expected that focused inspections of around 30 care homes will be undertaken later this year and the organisations hope to publish their findings in early 2009.

Prison Service

Stuart McMillan (West of Scotland) (SNP): To ask the Scottish Executive whether there is a limit to the number of community service orders that can be given to an individual before a prison sentence is imposed.

Kenny MacAskill: There is no such limit. Courts have regard to the specific circumstances of the offence and the individual offender, before deciding on a sentence.

Public Services

Joe FitzPatrick (Dundee West) (SNP): To ask the Scottish Executive when it will provide an update on its work to improve external scrutiny, following Professor Crerar’s review of regulation, audit, inspection and complaints handling.

John Swinney: I have today written to the convener of the Finance Committee with an update of the actions that the Scottish Government has taken since we published our response to Professor Crerar’s review. The update sets out a number of actions that are under way. They will help to deliver a more proportionate system of scrutiny which gives more trust and responsibility to service delivery bodies to deliver and improve services but maintains the assurances that independent assessment of key services provides.

  A copy of the letter has been placed in the Scottish Parliament Information Centre (Bib 45957).

Student Finance

Claire Baker (Mid Scotland and Fife) (Lab): To ask the Scottish Executive what guidance and allocations for discretionary funds in the 2008-09 academic year were sent to the Student Awards Agency for Scotland on 6 June 2008 for distribution to all institutions.

Fiona Hyslop: The information sent to the Student Awards Agency for Scotland on 6 June comprises a guidance document which provides general advice to administrators of the discretionary funds. As these funds are discretionary, it is up to each individual institution to decide how best to manage and distribute the funds available to them. The Higher Education and Learner Support Division provides general guidance on administration and disbursement of the funds and also notification of any changes to the funds through an annual update of this document. We also advise each institution of the allocation of discretionary funds that they will receive for the forthcoming academic year.

  A copy of the Guidance document and the allocations for academic year 2008-09 can be accessed via the SAAS website at http://www.saas.gov.uk/student_support/other_funding.htm#discretionary.

Suicide

Dr Richard Simpson (Mid Scotland and Fife) (Lab): To ask the Scottish Executive what funds have been allocated to support the Choose Life programme in (a) 2006-07, (b) 2007-08, and (c) 2008-09, also broken down by local authority area.

Shona Robison: The Scottish Government allocated £8.6 million over 2006-08 for the further implementation of Choose Life. National activities, led by the Choose Life national implementation team, received £2 million over 2006-08. Local activities received a total of £6.6 million over 2006-08.

  Funding allocation to each local authority for Choose Life for 2006-07 and 2007-8 is recorded in the following table:

  

 Area
2006-07 Allocation (£000)
2007-08 Allocation (£000)


 Aberdeen City
 114
 114


 Aberdeenshire
 117
 117


 Angus
 87
 87


 Argyll and Bute
 83
 83


 Clackmannanshire
 72
 72


 Dumfries and Galloway
 97
 97


 Dundee City
 97
 97


 East Ayrshire
 90
 90


 East Dunbartonshire
 87
 87


 East Lothian
 83
 83


 East Renfrewshire
 83
 83


 Edinburgh, City of
 173
 173


 Eilean Siar
 67
 67


 Falkirk
 97
 97


 Fife
 148
 148


 Glasgow City
 206
 206


 Highland
 213
 213


 Inverclyde
 81
 81


 Midlothian
 80
 80


 Moray
 82
 82


 North Ayrshire
 94
 94


 North Lanarkshire
 141
 141


 Orkney Islands
 65
 65


 Perth and Kinross
 94
 94


 Renfrewshire
 104
 104


 Scottish Borders
 87
 87


 Shetland Islands
 66
 66


 South Ayrshire
 88
 88


 South Lanarkshire
 136
 136


 Stirling
 82
 82


 West Dunbartonshire
 84
 84


 West Lothian
 100
 100


 Total
 3,198 million
 3,198 million



  Following spending review 2007, £1.2 million is allocated for national Choose Life activity for 2008-09. Following the concordat between government and COSLA, funding for local suicide prevention activity will be drawn from the overall funding provided to local authorities, and will be determined by local need.

Suicide

Dr Richard Simpson (Mid Scotland and Fife) (Lab): To ask the Scottish Executive what funding will be allocated to support the Choose Life programme in 2009-10 and 2010-11.

Shona Robison: Following Spending Review 2007, £1.2 million is allocated to national Choose Life activity for each of 2009-10 and 2010-11.

  In line with the concordat between government and COSLA, funding for local suicide prevention activity will be drawn from the overall funding provided to local authorities, and will be determined by local need. Total funding to local government for 2008-11 is £34.7 billion; split £11.1 billion/£11.6 billion/£12 billion.